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Ishibashi Y, Takama N, Ohtaki Y, Koitabashi N, Kurabayashi M, Ishii H. Pyothorax and Constrictive Pericarditis after Chemoradiotherapy for Esophageal Cancer. Intern Med 2024; 63:1387-1393. [PMID: 37839880 DOI: 10.2169/internalmedicine.2502-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
A 75-year-old man underwent chemoradiotherapy for advanced esophageal cancer. After nine years, he was hospitalized for left pyothorax. Consequently, the patient underwent drainage and window opening surgery. He experienced cardiopulmonary arrest but was resuscitated. Based on cardiac catheterization data, the patient was diagnosed with constrictive pericarditis. Unfortunately, extracorporeal circulation did not improve his condition, and he ultimately died. An autopsy revealed adhesion between the pericardium and pleura, especially the pericardium in contact with the left thoracic cavity, which was markedly thickened. This suggests that constrictive pericarditis, a latent complication of chemoradiotherapy, is aggravated by pyothorax.
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Affiliation(s)
- Yohei Ishibashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
- Department of Cardiology, National Hospital Organization Takasaki General Medical Center, Japan
| | - Noriaki Takama
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yoichi Ohtaki
- Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, Japan
| | - Norimichi Koitabashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
| | - Masahiko Kurabayashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
| | - Hideki Ishii
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
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Gillombardo CB, Hoit BD. Constrictive pericarditis in the new millennium. J Cardiol 2024; 83:219-227. [PMID: 37714264 DOI: 10.1016/j.jjcc.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023]
Abstract
Constrictive pericarditis (CP) is a complex clinical syndrome in which an inflamed pericardium becomes fibrotic and non-compliant, ultimately reducing cardiac pump performance. Although we have known about CP for centuries, it remains a challenge to diagnose. Recent advances in cardiac imaging, along with an expanding armamentarium of treatment options, have improved the quality and precision of care for patients with CP. This article reviews important historical and contemporary perspectives on the pathophysiology of CP, as well as our approach to diagnosis and management.
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Affiliation(s)
- C Barton Gillombardo
- Harrington Heart and Vascular Institute, University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Brian D Hoit
- Harrington Heart and Vascular Institute, University Hospital Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA.
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Aoyagi H, Tsujinaga S, Takahashi Y, Naito S, Sato T, Otsuka T, Tamaki Y, Motoi K, Ishizaka S, Chiba Y, Kamiya K, Iwano H, Nagai T, Wakasa S, Anzai T. Multimodal Imaging of Constrictive Pericarditis Induced by Long-term Pergolide Treatment for Parkinson's Disease. Intern Med 2023; 62:3637-3641. [PMID: 37005266 PMCID: PMC10781551 DOI: 10.2169/internalmedicine.1381-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/12/2023] [Indexed: 04/03/2023] Open
Abstract
We herein report the first case of constrictive pericarditis (CP) induced by long-term pergolide treatment for Parkinson's disease that was assessed using multimodal imaging in a 72-year-old patient with leg edema and dyspnea. The patient was correctly diagnosed with CP using multimodal imaging and successfully treated with pericardiectomy. The treatment history of Parkinson's disease and pathological findings of the removed pericardium suggested that long-term pergolide was the cause of CP. Properly recognizing pergolide as the cause of CP and accurately diagnosing CP using multimodal imaging may contribute to the early detection and treatment of pergolide-induced CP.
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Affiliation(s)
- Hiroyuki Aoyagi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Shingo Tsujinaga
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Department of Cardiology, Hokkaido Ohno Memorial Hospital, Japan
| | - Yuki Takahashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Seiichiro Naito
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuma Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Takuya Otsuka
- Department of Surgical Pathology, Hokkaido University Hospital, Japan
| | - Yoji Tamaki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Ko Motoi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Suguru Ishizaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yasuyuki Chiba
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Hiroyuki Iwano
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
- Department of Cardiovascular Medicine, Teine Keijinkai Hospital, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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Duarte F, Oliveira L, Fontes T, Ramos S, Dourado R, Martins D. Chronic constrictive pericarditis: a rare cardiac involvement in primary Sjögren's syndrome. BMC Cardiovasc Disord 2023; 23:471. [PMID: 37730569 PMCID: PMC10512490 DOI: 10.1186/s12872-023-03491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 09/02/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Constrictive pericarditis represents a chronic condition and systemic inflammatory diseases are a known, yet uncommon, cause. Pericardial involvement is seldom reported in primary Sjögren's syndrome, usually occurring in association with pericardial effusion or pericarditis. We report a case of constrictive pericarditis with an insidious course and unusual evolution associated with primary Sjögren's syndrome. Due to the challenging nature of the diagnosis, clinical suspicion and multimodality imaging are essential for early identification and prompt initiation of treatment. Long-term outcomes remain uncertain. To the best of our knowledge, no other cases linking this autoimmune disease to constrictive pericarditis have been reported. CASE PRESENTATION We present the case of a 48-year-old male patient with moderate alcohol habits and a history of two prior hospitalizations. On the first, the patient was diagnosed with primary Sjögren's syndrome after presenting with pleural effusion and ascites, and empirical corticosteroid regiment was initiated. On the second, two-years later, he was readmitted with complaints of dyspnea and abdominal distension. Thoracic computed tomography revealed a localized pericardial thickening and a thin pericardial effusion, both of which were attributed to his rheumatic disease. A liver biopsy showed hepatic peliosis, which was considered to be a consequence of glucocorticoid therapy. Diuretic therapy was adjusted to symptom-relief, and a tapering corticosteroid regimen was adopted. Four years after the initial diagnosis, the patient was admitted again with recurrent dyspnea, orthopnea and ascites. At this time, constrictive pericarditis was diagnosed and a partial pericardiectomy was performed. Although not completely asymptomatic, the patient reported clinical improvement since the surgery, but still with a need for baseline diuretic therapy. CONCLUSION Albeit uncommon, connective tissue disorders, such as primary Sjögren's syndrome, should be considered as a potential cause of constrictive pericarditis, especially in young patients with no other classical risk factors for constriction. In this case, after excluding possible infectious, neoplastic and autoimmune conditions, a primary Sjögren´s syndrome in association with constrictive pericarditis was assumed. This case presents an interesting and challenging clinical scenario, highlighting the importance of clinical awareness and the use of multimodal cardiac imaging for early recognition and treatment.
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Affiliation(s)
- Fabiana Duarte
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPER, São Miguel Island, Avenida D. Manuel I 9500-370, Azores, Portugal.
| | - Luís Oliveira
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPER, São Miguel Island, Avenida D. Manuel I 9500-370, Azores, Portugal
| | - Tomás Fontes
- Rheumatology Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPER, São Miguel Island, Avenida D. Manuel I 9500-370, Azores, Portugal
| | - Sância Ramos
- Anatomical Pathology Department, Hospital of Santa Cruz, Centro Hospitalar, Lisboa Ocidental, Portugal
| | - Raquel Dourado
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPER, São Miguel Island, Avenida D. Manuel I 9500-370, Azores, Portugal
| | - Dinis Martins
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPER, São Miguel Island, Avenida D. Manuel I 9500-370, Azores, Portugal
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Kim EE, Jeon YK, Koh J. A Case of Hodgkin Lymphoma Presenting Initially with Constrictive Pericarditis. Int J Surg Pathol 2023; 31:1115-1118. [PMID: 36172638 DOI: 10.1177/10668969221118914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eric Eunshik Kim
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea
- Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - Jiwon Koh
- Department of Pathology, Seoul National University Hospital, Seoul, South Korea
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Tchana-Sato V, Ancion A, Ansart F, Lardinois MJ, Dulgheru R, Somja J, Delvenne P, Defraigne JO. Constrictive pericarditis following cardiac transplantation: a report of two cases and a literature review. Acta Cardiol 2023; 78:763-772. [PMID: 37171264 DOI: 10.1080/00015385.2023.2209405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/16/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
The data on constrictive pericarditis following heart transplantation are scarce. Herein, the authors present 2 patients who developed a constrictive pericarditis 19, and 55 months after heart transplantation. They underwent several diagnostic procedures and successfully recovered after a radical pericardiectomy. In addition, the authors review the literature and report the incidence, aetiology, diagnostic features, and management of this rare and challenging condition.
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Affiliation(s)
| | | | - Francois Ansart
- Department of Cardiovascular Surgery, CHU Liege, Liege, Belgium
| | | | | | - Joan Somja
- Department of Pathology, CHU Liege, Liege, Belgium
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Reddy P, Kane GC, Oh JK, Luis SA. The Evolving Etiologic and Epidemiologic Portrait of Pericardial Disease. Can J Cardiol 2023; 39:1047-1058. [PMID: 37217161 DOI: 10.1016/j.cjca.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
Pericardial disease includes a variety of conditions, including inflammatory pericarditis, pericardial effusions, constrictive pericarditis, pericardial cysts, and primary and secondary pericardial neoplasms. The true incidence of this varied condition is not well established, and the causes vary greatly across the world. This review aims to describe the changing pattern of epidemiology of pericardial disease and to provide an overview of causative etiologies. Idiopathic pericarditis (assumed most often to be viral) remains the most common etiology for pericardial disease globally, with tuberculous pericarditis being most common in developing countries. Other important etiologies include fungal, autoimmune, autoinflammatory, neoplastic (both benign and malignant), immunotherapy-related, radiation therapy-induced, metabolic, postcardiac injury, postoperative, and postprocedural causes. Improved understanding of the immune pathophysiological pathways has led to identification and reclassification of some idiopathic pericarditis cases into autoinflammatory etiologies, including immunoglobulin G (IgG)4-related pericarditis, tumour necrosis factor receptor-associated periodic syndrome (TRAPS), and familial Mediterranean fever in the current era. Contemporary advances in percutaneous cardiac interventions and the recent COVID-19 pandemic have also resulted in changes in the epidemiology of pericardial diseases. Further research is needed to improve our understanding of the etiologies of pericarditis, using the assistance of contemporary advanced imaging techniques and laboratory testing. Careful consideration of the range of potential causes and local epidemiologic patterns of causality are important for the optimization of diagnostic and therapeutic approaches.
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Affiliation(s)
- Prajwal Reddy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Garvan C Kane
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jae K Oh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sushil Allen Luis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
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Ahmed AS, Divani G, Rai N. Left Ventricular Angiogram in Constrictive Pericarditis. J Invasive Cardiol 2022; 34:E756. [PMID: 36201001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 14-year-old boy presented with dyspnea on exertion and easy fatiguability for 1 year. He also had an episode of pedal edema 6 months prior, which resolved with diuretics. He had a history of tuberculosis treated with a 6-month course of antitubercular therapy. After a series of tests and analyses, it was evident that longitudinal contraction of the left ventricle was preserved, whereas the circumferential contraction was severely impaired. Pericardial calcification also could be seen encircling the left and right ventricles. Pericardial calcification is evident in around 25% of cases of constrictive pericarditis and predominantly seen in those with tubercular and pyogenic etiology. The subepicardial myocardial fibers are responsible for radial shortening and subendocardial fibers are responsible for longitudinal shortening. In constrictive pericarditis, the involvement of the subepicardial fibers leads to reduction in the circumferential shortening. The patient was referred for pericardiectomy.
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Affiliation(s)
- A Shaheer Ahmed
- Department of Cardiology, 7th Floor, Super Speciality Block, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India.
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9
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Abstract
PURPOSE OF REVIEW Thyroid disorders, especially hypothyroidism, are known to be associated with pericardial diseases. The aim of this paper is to review the current knowledge of the pericardial manifestations of hypothyroidism and hyperthyroidism. RECENT FINDINGS Many reports have described associations between dysthyroidism, which encompasses hypothyroidism and hyperthyroidism, and several pericardial diseases, including acute pericarditis, constrictive pericarditis, pericardial effusion, and tamponade. The diagnosis of dysthyroidism-induced pericardial diseases consists of a combination of thyroid blood levels that fall outside of the normal range and the exclusion of other causes. Treatment of the thyroid disorder is key, along with treatment of the pericardial disease as recommended by the guidelines. Early recognition of the thyroid disorder is key in patients with pericardial diseases, since treating the underlying cause should assist resolution of the pericardial issues and ideally prevent recurrence and possible future complications of suboptimally treated pericarditis or pericardial effusions.
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Affiliation(s)
- Johnny Chahine
- Department of Cardiovascular Disease, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Zeina Jedeon
- Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kevin Y Chang
- Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Christine L Jellis
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
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Nakanishi Y, Honda S, Yamano M, Kawasaki T, Yoshioka K. Constrictive pericarditis after SARS-CoV-2 vaccination: A case report. Int J Infect Dis 2022; 116:238-240. [PMID: 35063679 PMCID: PMC8767927 DOI: 10.1016/j.ijid.2022.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/30/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are associated with cardiovascular complications. Here, we report a case of right-sided heart failure caused by constrictive pericarditis that developed after the administration of messenger ribonucleic acid (mRNA) vaccine against SARS-CoV-2. A 70-year-old woman presented with body weight gain, peripheral edema, and dyspnea on effort, which developed over a period of 1 week after the second dose of vaccine. The jugular venous pressure was high with a prominent y descent (Friedreich's sign) and paradoxical increase on inspiration (Kussmaul's sign). The results of IgM and IgG testing specific to SARS-CoV-2 spike and nucleocapsid proteins indicated the presence of mRNA vaccine-induced antibody and were not suggestive of COVID-19 infection. Echocardiography showed pericardial thickening and septal bounce of the interventricular septum. Computed tomography (CT) also showed pericardial thickening compared with the results of the previous CT scan performed 4 months earlier. A diagnosis of right-sided heart failure due to constrictive pericarditis was confirmed on the basis of pressure analysis during cardiac catheterization.
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Affiliation(s)
- Yuki Nakanishi
- Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Sakiko Honda
- Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.
| | - Michiyo Yamano
- Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Tatsuya Kawasaki
- Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
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Barbina S, Kavin U, Sutton MM, Heincelman M, Thomas MK. Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients. J Investig Med High Impact Case Rep 2022; 10:23247096221097530. [PMID: 35546528 PMCID: PMC9112309 DOI: 10.1177/23247096221097530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
Although well documented, constrictive pericarditis is a rare entity and an uncommon cause of heart failure. A stiff and noncompliant pericardium creates the disease's unique hemodynamics and leads to elevated venous pressures, hepatic sinusoidal congestion, and draining of protein-rich fluid into the peritoneal cavity presenting as ascites. The low incidence in addition to its varied and subtle clinical presentations can often lead to a delay in diagnosis. Here, we present 2 clinical cases of constrictive pericarditis in which ascitic fluid analysis was important-one patient who presented with new-onset ascites with concern for cirrhosis and another patient who presented with symptoms concerning for heart failure with ascites. Through their hospital course and workup, we highlight the importance of diagnostic sampling of ascitic fluid to prompt the consideration of constrictive pericarditis followed by utilizing advanced diagnostics, such as echocardiogram and cardiac catheterization to reach the correct diagnosis in an otherwise often overlooked pathology.
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Affiliation(s)
- Sarah Barbina
- Department of Medicine, Medical
University of South Carolina, Charleston, USA
| | - Umakanthan Kavin
- Department of Medicine, Medical
University of South Carolina, Charleston, USA
| | - Michael M. Sutton
- Department of Medicine, Medical
University of South Carolina, Charleston, USA
| | - Marc Heincelman
- Department of Medicine, Medical
University of South Carolina, Charleston, USA
| | - Meghan K. Thomas
- Department of Medicine, Medical
University of South Carolina, Charleston, USA
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12
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Iemura J, Yamamoto Y, Kambara A, Fujii K. [Constrictive Pericarditis with Multiple Organ Failure after Coronary Artery Bypass Grafting]. Kyobu Geka 2021; 74:903-907. [PMID: 34601471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 67-year-old male patient, who had undergone coronary artery bypass grafting (CABG) 16 years before, developed congestive heart failure 5 years after surgery. Three years later, he developed repeated heart failure, sepsis by methicillin-resistant Staphylococcus aureus (MRSA), renal failure, repeated thrombophlebitis on his right leg and atrial fibrillation. He also suffered from clouding of consciousness and flapping tremor caused by hyperammonemia. The three bypass grafts showed normal flow, but the pericardium was severely thickened. Therefore, pericardiotomy was performed via median sternotomy with additional left thoracotomy without using cardiopulmonary bypass. Although, he developed MRSA mediastinitis after surgery, he recovered after a month of continuous negative pressure wound therapy. His liver function and septic conditions gradually recovered. No recurrence of heart failure has been observed for 8 years since his second surgery.
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Affiliation(s)
- Junzo Iemura
- Department of Cardiovascular Surgery, Okanami General Hospital, Iga, Japan
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13
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Paneer SKM, Christina SR, Adli Azam MR, Balachandran K, Deventhiran P. Complete resolution of constrictive pericarditis after coronary bypass surgery. Med J Malaysia 2021; 76:747-749. [PMID: 34508388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Classical constrictive pericarditis (CP) is an unusual and rare complication after coronary artery bypass grafting. It can be transient, progressive or fixed form of cardiac constriction. However recently recognized transient variant of constrictive pericarditis can be managed with medical therapy, though other progressive and irreversible forms may require pericardiectomy. We describe a 65-year-old male patient who developed a classical but a very early transient CP, just within two weeks as a result of post cardiac injury syndrome after coronary bypass surgery. The patient had a complete recovery following medical treatment.
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Affiliation(s)
- S K M Paneer
- National Heart Institute, Department of Cardiothoracic Surgery, 50400 Kuala Lumpur, Malaysia.
| | - S R Christina
- National Heart Institute, Department of Cardiothoracic Surgery, 50400 Kuala Lumpur, Malaysia
| | - M R Adli Azam
- National Heart Institute, Department of Cardiothoracic Surgery, 50400 Kuala Lumpur, Malaysia
| | - K Balachandran
- National Heart Institute, Department of Cardiology, 50400 Kuala Lumpur, Malaysia
| | - P Deventhiran
- National Heart Institute, Department of Non-Invasive Cardiac Laboratory, 50400 Kuala Lumpur, Malaysia
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14
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Martínez-Gómez E, Higueras J, Olmos C. Constrictive physiology due to epicardial fat. Rev Esp Cardiol (Engl Ed) 2020; 73:1066-1068. [PMID: 32600995 DOI: 10.1016/j.rec.2020.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Affiliation(s)
| | - Javier Higueras
- Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmen Olmos
- Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
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15
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Gumireddy SR, Chaliki HP, Cummings KW, Freeman WK. Systemic Lupus Erythematosus Presenting As Constrictive Pericarditis. Circ Cardiovasc Imaging 2020; 13:e010254. [PMID: 32912029 DOI: 10.1161/circimaging.119.010254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Srikala R Gumireddy
- Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ (S.R., H.P.C., W.K.F.)
| | - Hari P Chaliki
- Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ (S.R., H.P.C., W.K.F.)
| | | | - William K Freeman
- Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ (S.R., H.P.C., W.K.F.)
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Vogiatzi G, Aznaouridis K, Tolis P, Tsiamis E, Tousoulis D. Jailed in a Bony Prison: Post-tuberculotic Calcific Constrictive Pericarditis. Am J Med Sci 2020; 359:188-189. [PMID: 31787226 DOI: 10.1016/j.amjms.2019.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/13/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Georgia Vogiatzi
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece.
| | - Konstantinos Aznaouridis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Tolis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Eleftherios Tsiamis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
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Taguchi S, Kitamura T, Matsukuma S, Odate T, Ariyoshi T, Hamawaki M, Otsubo C, Kurohama H, Mihara Y. A case of recurrent constrictive pericarditis induced by pericardial substitution with an expanded polytetrafluoroethylene membrane. Gen Thorac Cardiovasc Surg 2020; 68:1479-1482. [PMID: 32008186 DOI: 10.1007/s11748-020-01303-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/24/2020] [Indexed: 11/30/2022]
Abstract
A 72-year-old man presented with recurrent constrictive pericarditis, which developed 6 months after pericardiectomy, and pericardial substitution with an expanded polytetrafluoroethylene membrane. Re-pericardiectomy was performed. A new thick membranous structure had grown under the expanded polytetrafluoroethylene membrane anterior to the right ventricle, and was firmly adhered to the epicardium. This new structure exhibited collagenous fiber-based fibrotic thickening, and resembled a foreign body reaction. It was surmised that recurrence of constrictive pericarditis may have been induced by the expanded polytetrafluoroethylene membrane. Heart failure resolved after the operation; however, the patient died of respiratory failure on postoperative day 6.
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Affiliation(s)
- Shunsuke Taguchi
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan.
| | - Tessho Kitamura
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Seiji Matsukuma
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Tomohiro Odate
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Tsuneo Ariyoshi
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Masayoshi Hamawaki
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Chieko Otsubo
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Hirokazu Kurohama
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
| | - Yumi Mihara
- Department of Cardiovascular Surgery and Pathology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562, Japan
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18
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Valentin R, Keeley EC, Ataya A, Gomez-Manjarres D, Petersen J, Arnaoutakis GJ, Drew P, Barnes M, Patel DC. Breaking hearts and taking names: A case of sarcoidosis related effusive-constrictive pericarditis. Respir Med 2020; 163:105879. [PMID: 32056834 DOI: 10.1016/j.rmed.2020.105879] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/24/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Pericardial involvement of sarcoidosis is a rare cause for acute heart failure, and usually occurs as a result of the development of a pericardial effusion leading to cardiac tamponade. Even rarer still, is the manifestation of constrictive pericarditis. We report a case of sarcoidosis with lung, pleural, and pericardial involvement with effusive-constrictive pericarditis leading to cardiac tamponade. CASE PRESENTATION A 34-year-old Caucasian man presented for evaluation of a history of worsening exertional dyspnea, edema, and weight loss. A high-resolution chest computed tomography showed diffuse pulmonary nodules with upper lobe predominance and in a perilymphatic distribution; large right pleural effusion; and large pericardial effusion with pericardial thickening. A transthoracic echocardiogram demonstrated early tamponade physiology for which a pericardial drain was placed. After removal of the drain he developed cardiogenic shock from cardiac tamponade attributed to the reaccumulation of a pericardial effusion and urgent pericardial window was performed. Serial echocardiography was concerning for organization and localization of the pericardial fluid. Cardiac magnetic resonance imaging demonstrated a significant reduction in pericardial slippage between the parietal and visceral layers around the heart collectively suggestive of constrictive pericarditis. Confirmation of effusive-constrictive pericarditis was noted on right heart catheterization. He then underwent pericardiectomy, which on histopathologic evaluation demonstrated non-necrotizing granulomas, thus confirming pericardial involvement of sarcoidosis. CONCLUSIONS We report a case demonstrating unique manifestations of sarcoidosis; effusive-constrictive pericarditis presenting with acute congestive heart failure.
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Affiliation(s)
- Ramon Valentin
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Ellen C Keeley
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Ali Ataya
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Diana Gomez-Manjarres
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - John Petersen
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - George J Arnaoutakis
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Peter Drew
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Matt Barnes
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Divya C Patel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA.
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19
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Pessinaba S, Sonhaye L, Agbétiafa M, Wossinu Quacoe M, Aloumon M, Yayehd K, Amadou L, d'Alméida R, Damorou F. [The chronic constrictive pericarditis, a real calcified gangue realizing a mid-ventricular bottleneck: A case report]. Ann Cardiol Angeiol (Paris) 2019; 68:125-128. [PMID: 30149893 DOI: 10.1016/j.ancard.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
A 30-year-old woman consulted for a predominantly right-sided global heart failure chart that had been evolving for about 3 months. Its antecedents include a concept of poorly treated pleuropulmonary tuberculosis at the age of 8 years. Lateral chest X-ray, transthoracic echocardiography and thoracic CT showed ventricular ring calcification with mid-ventricular compression with apical ballooning. The diagnosis of chronic mid-ventricular constrictive pericarditis of tuberculosis etiology was retained. The patient was put on diuretic treatment and the immediate evolution is favorable with a regression of the signs of congestion. Surgical decortication has been indicated.
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Affiliation(s)
- S Pessinaba
- Service cardiologie, CHU de Campus, Lomé, Togo.
| | - L Sonhaye
- Service de radiologie et d'imagerie médicale, CHU de Campus, Lomé, Togo
| | - M Agbétiafa
- Service cardiologie, CHU de Campus, Lomé, Togo
| | | | - M Aloumon
- Service cardiologie, CHU de Campus, Lomé, Togo
| | - K Yayehd
- Service cardiologie, CHU de Campus, Lomé, Togo
| | - L Amadou
- Service de radiologie et d'imagerie médicale, CHU de Campus, Lomé, Togo
| | - R d'Alméida
- Service cardiologie, CHU de Campus, Lomé, Togo
| | - F Damorou
- Service cardiologie, CHU de Campus, Lomé, Togo
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20
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Abstract
Pericardial cysts are rare abnormalities and are usually asymptomatic. Although several case reports on their diagnosis and treatment have been published, those on hemorrhagic pericardial cysts remain limited. We herein report the case of a 70-year-old man with a hemorrhagic pericardial cyst complicated with constrictive pericarditis 2 years after the initial diagnosis.
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Affiliation(s)
| | - Shiou Ohguchi
- Department of Cardiology, Kasugai Municipal Hospital, Japan
| | | | | | - Yuki Yokoi
- Department of Cardiology, Kasugai Municipal Hospital, Japan
| | - Kazuhiro Izumi
- Department of Cardiology, Kasugai Municipal Hospital, Japan
| | - Takashi Fujita
- Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, Japan
| | - Kei Yagami
- Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, Japan
| | - Masato Mutsuga
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Japan
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21
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Kalińczuk Ł, Markiewicz MG, Rzeszutko M, Pastuszek-Tyc M, Kuśmierczyk M, Demkow M. Additive value of a novel 384-row CT insight into the actual pathomechanism of a constrictive pericarditis and its effective surgical treatment guided by the pre-procedural detailed imaging. J Cardiovasc Comput Tomogr 2018; 14:e97-e98. [PMID: 30509775 DOI: 10.1016/j.jcct.2018.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/05/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Łukasz Kalińczuk
- Institute of Cardiology, Alpejska 42 St., 04-628, Warsaw-Anin, Poland.
| | - Michał G Markiewicz
- Medical University of Warsaw, Żwirki i Wigury 61 St., 02-091, Warsaw, Poland
| | - Marzena Rzeszutko
- Medical University of Warsaw, Żwirki i Wigury 61 St., 02-091, Warsaw, Poland
| | | | | | - Marcin Demkow
- Institute of Cardiology, Alpejska 42 St., 04-628, Warsaw-Anin, Poland
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22
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Kawaguchi H, Tsuboi H, Yagishita M, Terasaki T, Terasaki M, Shimizu M, Honda F, Ohyama A, Takahashi H, Miki H, Yokosawa M, Asashima H, Hagiwara S, Kondo Y, Matsumoto I, Sumida T. Severe Adult-onset Still Disease with Constrictive Pericarditis and Pleuritis That Was Successfully Treated with Tocilizumab in Addition to Corticosteroids and Cyclosporin A. Intern Med 2018; 57:1033-1038. [PMID: 29269680 PMCID: PMC5919867 DOI: 10.2169/internalmedicine.9809-17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Adult-onset Still disease (AOSD) is a systemic inflammatory disease characterized by fever, arthritis and rash. Corticosteroids represent a promising therapeutic option for AOSD; however, some resistant cases require immunosuppressants and biologic agents. We herein report the case of a 29-year-old Japanese man with severe AOSD, accompanied by constrictive pericarditis (CP) and pleuritis. Although 2 courses of steroid pulse and subsequent high-dose of prednisolone and cyclosporine A improved the patient's CP and pleuritis, his fever and inflammatory responses persisted. Tocilizumab (TCZ) was added to his treatment, which resulted in a rapid remission. This case suggests the usefulness of TCZ in the treatment of severe AOSD with CP and pleuritis.
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Affiliation(s)
- Hoshimi Kawaguchi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroto Tsuboi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Mizuki Yagishita
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Toshihiko Terasaki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Mayu Terasaki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Masaru Shimizu
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Fumika Honda
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Ayako Ohyama
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroyuki Takahashi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Haruka Miki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Masahiro Yokosawa
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiromitsu Asashima
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Shinya Hagiwara
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Yuya Kondo
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Isao Matsumoto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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23
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Kageyama R, Ueno K, Sunada M, Midorikawa H, Kanno M, Takano T, Satou K. [Constrictive Pericarditis with Intractable Ascites after Aortic Valve Replacement;Report of a Case]. Kyobu Geka 2018; 71:218-221. [PMID: 29755076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We report a 68-year-old man, who developed refractory ascites of unknown cause after aortic valve replacement. He was diagnosed with constrictive pericarditis because of "dip-and-plateau" waveform findings via cardiac catheterization and operated with cardiopulmonary bypass. Following waffle procedure, we incised pericardium for decompression, so that pericardial mobility and diastolic dysfunction was improved. Postoperative computed tomography (CT) image also showed decrease of ascites fluid. We concluded that pericardiotomy is an established surgical procedure and is excellent indication to constrictive pericarditis.
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Affiliation(s)
- Rie Kageyama
- Department of Cardiovascular Surgery, Southern Tohoku General Hospital, Koriyama, Japan
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24
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Yeneneh BT, Allen S, Panse P, Mookadam F, Rule W. Constrictive Pericarditis 5 Months after Radiation Therapy in a 62-Year-Old Woman with Esophageal Cancer. Tex Heart Inst J 2017; 44:411-415. [PMID: 29276442 DOI: 10.14503/thij-16-6054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most pericardial changes appear within a few weeks in patients who have undergone radiation therapy for thoracic neoplasms. Chronic pericardial constriction typically occurs decades later, consequent to fibrosis. Early constrictive pericarditis after chest irradiation is quite rare. We report the case of a 62-year-old woman who underwent radiation therapy for esophageal cancer and presented with constrictive pericarditis 5 months later. We searched the English-language medical literature from January 1986 through December 2015 for reports of early constrictive pericarditis after irradiation for thoracic malignancies. We defined "early" as a diagnosis within one year after radiation therapy. Five cases fit our criteria, and we summarize the findings here. To our knowledge, ours is the first definitive report of a patient with esophageal cancer to present with early radiation-induced constrictive pericarditis. We conclude that constrictive pericarditis can occur early after radiation for thoracic malignancies, albeit rarely. When planning care for cancer patients, awareness of this sequela is helpful.
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25
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Fernández-Codina A, Francisco-Pascual J, Fonollosa-Plà V. Tratamiento exitoso de un caso de pericarditis crónica constrictiva utilizando micofenolato sódico en una paciente con esclerosis sistémica. Med Clin (Barc) 2017; 148:574-575. [PMID: 28283274 DOI: 10.1016/j.medcli.2017.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/06/2017] [Accepted: 01/12/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Andreu Fernández-Codina
- Unidad de Enfermedades Autoinmunes Sistémicas, Departamento de Medicina Interna, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
| | - Jaume Francisco-Pascual
- Departamento de Cardiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - Vicent Fonollosa-Plà
- Unidad de Enfermedades Autoinmunes Sistémicas, Departamento de Medicina Interna, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
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26
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Abstract
INTRODUCTION Radiation-induced heart disease (RIHD) is a serious side effect of cancer treatment, including coronary artery disease, valvular cardiac dysfunction, cardiomyopathy, aortopathy, and chronic constrictive pericarditis. Herein, this case we present was diagnosed as radiation-induced constrictive pericarditis and cardiomyopathy by means of cardiac magnetic resonance (CMR) and transthoracic echocardiogram, finally confirmed by pathology after performing heart transplant operation. CONCLUSIONS This case supports a notion that RIHD often causes multiple heart impairment and CMR is helpful to diagnose cardiomyopathy after radiation.
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Affiliation(s)
| | | | | | - Zhong-kai Liao
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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27
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Jung IY, Song YG, Choi JY, Kim MH, Jeong WY, Oh DH, Kim YC, Song JE, Kim EJ, Lee JU, Jeong SJ, Ku NS, Kim JM. Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus-uninfected patients in an intermediate tuberculosis burden country. BMC Infect Dis 2016; 16:719. [PMID: 27899066 PMCID: PMC5129391 DOI: 10.1186/s12879-016-2062-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 11/23/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In areas where Mycobacterium tuberculosis is endemic, tuberculosis is known to be the most common cause of pericarditis. However, the difficulty in diagnosis may lead to late complications such as constrictive pericarditis and increased mortality. Therefore, identification of patients at a high risk for poor prognosis, and prompt initiation of treatment are important in the outcome of TB pericarditis. The aim of this study is to identify the predictive factors for unfavorable outcomes of TB pericarditis in HIV-uninfected persons in an intermediate tuberculosis burden country. METHODS A retrospective review of 87 cases of TB pericarditis diagnosed at a tertiary referral hospital in South Korea was performed. Clinical characteristics, treatment outcomes, complications during treatment, duration of treatment, and medication history were reviewed. Unfavorable outcome was defined as constrictive pericarditis identified on echocardiography performed 3 to 6 months after initial diagnosis of TB pericarditis, cardiac tamponade requiring emergency pericardiocentesis, or death. Predictive factors for unfavorable outcomes were identified. RESULTS Of the 87 patients, 44 (50.6%) had unfavorable outcomes; cardiac tamponade (n = 36), constrictive pericarditis (n = 18), and mortality (n = 4). 14 patients experienced both cardiac tamponade and constrictive pericarditis. During a 1 year out-patient clinic follow up, 4 patients required repeat pericardiocentesis and pericardiectomy was performed in 0 patients. In the multivariate analysis, patients with large amounts of pericardial effusion (P = .003), those with hypoalbuminemia (P = .011), and those without cardiovascular disease (P = .011) were found to have a higher risk of unfavorable outcomes. CONCLUSION HIV-uninfected patients with TB pericarditis are at a higher risk for unfavorable outcomes when presenting with low serum albumin, with large pericardial effusions, and without cardiovascular disease.
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Affiliation(s)
- In Young Jung
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Young Goo Song
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Jun Yong Choi
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Moo Hyun Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Woo Yong Jeong
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Dong Hyun Oh
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Yong Chan Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Je Eun Song
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Eun Jin Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Ji Un Lee
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - Su Jin Jeong
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea.
| | - Nam Su Ku
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
| | - June Myung Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Republic of Korea
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28
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Affiliation(s)
- Anastasios Milkas
- Cardiovascular Centre Aalst, OLV Clinic, Moorselbaan 164, Aalst B-9300, Belgium
- Athens Naval and Veterans Hospital, Deinokratous 70, Athens, Greece
| | - Carlos Van Mieghem
- Cardiovascular Centre Aalst, OLV Clinic, Moorselbaan 164, Aalst B-9300, Belgium
| | - Lieven Van Hoe
- Department of radiology, OLV hospital, Moorselbaan 164, Aalst 9300, Belgium
| | - Emanuele Barbato
- Cardiovascular Centre Aalst, OLV Clinic, Moorselbaan 164, Aalst B-9300, Belgium
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy
| | - Bernard De Bruyne
- Cardiovascular Centre Aalst, OLV Clinic, Moorselbaan 164, Aalst B-9300, Belgium
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29
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Sharma A, DeValeria PA, Scherber RM, Sugrue G, McCullough AE, Panse PM, Mookadam F. Angiosarcoma Causing Cardiac Constriction Late after Radiation Therapy for Breast Carcinoma. Tex Heart Inst J 2016; 43:81-3. [PMID: 27047293 DOI: 10.14503/thij-14-4549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Therapeutic radiotherapy rarely causes sarcoma, and this occurs years after completion of the intended treatment. In treating breast carcinoma, careful planning in the application of modern radiotherapeutic techniques usually can shield the heart and pericardium. We report a rare case of angiosarcoma of the pericardium, which presented in a 41-year-old woman as constrictive pericarditis 8 years after irradiation for cancer of the left breast. To our knowledge, this is only the 2nd report of angiosarcoma of the pericardium after radiotherapy.
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30
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Brucato A, D'Elia E, Pedrotti P, Valenti A, De Amici M, Fiocca L, Duino V, Senni M, Imazio M, Martini A. Reply to: "Effusive-constrictive pericarditis successfully treated with anakinra" G. Lazaros et al. Interleukin-1β receptor antagonist and pericardial constriction. Clin Exp Rheumatol 2015; 33:946. [PMID: 26517765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 06/05/2023]
Affiliation(s)
- A Brucato
- Internal Medicine Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - E D'Elia
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| | - P Pedrotti
- Cardiovascular Department, Ca' Granda Niguarda Hospital, Milan, Italy
| | - A Valenti
- Internal Medicine Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M De Amici
- Paediatric Clinic, IRCCS Polyclinic San Matteo, Pavia, Italy
| | - L Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - V Duino
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy
| | - A Martini
- University of Genova, Department of Paediatrics, IRCCS G. Gaslini, Genova, Italy
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31
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Lustig N, Florenzano P, Sanhueza LM, Cid X, Ramos G, Thone N, Fullerton DA. [Constrictive pericarditis as a serious and rare presentation of systemic lupus erythematosus: Report of one case]. Rev Med Chil 2015; 142:1065-8. [PMID: 25424680 DOI: 10.4067/s0034-98872014000800015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 08/18/2014] [Indexed: 11/17/2022]
Abstract
Constrictive Pericarditis (CP) is an unusual disease. Its most common causes are idiopathic or secondary to cardiac surgery. Less frequently it is caused by connective tissue diseases. We report a 30 years old woman hospitalized due to progressive dyspnea, chest pain and signs of right sided heart failure. During her stay, a Systemic Lupus Erythematosus (SLE) was diagnosed. The echocardiogram suggested a CP and the diagnosis was confirmed by cardiac catheterization. Pericardiectomy was successfully performed. The biopsy confirmed a nonspecific chronic pericarditis, with extensive fibrosis and absence of caseating granulomas. The patient had a satisfactory recovery.
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Seidler S, Lebowitz D, Müller H. [Chronic constrictive pericarditis]. Rev Med Suisse 2015; 11:1166-1171. [PMID: 26182634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Chronic constrictive pericarditis is a rare condition characterized by an impairment of myocardial relaxation due to limitation by a rigid pericardium. It is most often associated with infection, thoracic radiotherapy and heart surgery. Clinical features are that of chronic heart failure, therefore non-specific and resulting in a delay of several years before diagnosis is made. The echocardiogram and heart catheterization are part of the initial work-up. Surgical treatment consisting in pericardiectomy can be curative if the disease is recognised early. This article makes use of a case report and review of the litterature to discuss the physiopathology, clinical features and management of chronic constrictive pericarditis.
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Mayosi BM, Ntsekhe M, Bosch J, Pandie S, Jung H, Gumedze F, Pogue J, Thabane L, Smieja M, Francis V, Joldersma L, Thomas KM, Thomas B, Awotedu AA, Magula NP, Naidoo DP, Damasceno A, Chitsa Banda A, Brown B, Manga P, Kirenga B, Mondo C, Mntla P, Tsitsi JM, Peters F, Essop MR, Russell JBW, Hakim J, Matenga J, Barasa AF, Sani MU, Olunuga T, Ogah O, Ansa V, Aje A, Danbauchi S, Ojji D, Yusuf S. Prednisolone and Mycobacterium indicus pranii in tuberculous pericarditis. N Engl J Med 2014; 371:1121-30. [PMID: 25178809 PMCID: PMC4912834 DOI: 10.1056/nejmoa1407380] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Tuberculous pericarditis is associated with high morbidity and mortality even if antituberculosis therapy is administered. We evaluated the effects of adjunctive glucocorticoid therapy and Mycobacterium indicus pranii immunotherapy in patients with tuberculous pericarditis. METHODS Using a 2-by-2 factorial design, we randomly assigned 1400 adults with definite or probable tuberculous pericarditis to either prednisolone or placebo for 6 weeks and to either M. indicus pranii or placebo, administered in five injections over the course of 3 months. Two thirds of the participants had concomitant human immunodeficiency virus (HIV) infection. The primary efficacy outcome was a composite of death, cardiac tamponade requiring pericardiocentesis, or constrictive pericarditis. RESULTS There was no significant difference in the primary outcome between patients who received prednisolone and those who received placebo (23.8% and 24.5%, respectively; hazard ratio, 0.95; 95% confidence interval [CI], 0.77 to 1.18; P=0.66) or between those who received M. indicus pranii immunotherapy and those who received placebo (25.0% and 24.3%, respectively; hazard ratio, 1.03; 95% CI, 0.82 to 1.29; P=0.81). Prednisolone therapy, as compared with placebo, was associated with significant reductions in the incidence of constrictive pericarditis (4.4% vs. 7.8%; hazard ratio, 0.56; 95% CI, 0.36 to 0.87; P=0.009) and hospitalization (20.7% vs. 25.2%; hazard ratio, 0.79; 95% CI, 0.63 to 0.99; P=0.04). Both prednisolone and M. indicus pranii, each as compared with placebo, were associated with a significant increase in the incidence of cancer (1.8% vs. 0.6%; hazard ratio, 3.27; 95% CI, 1.07 to 10.03; P=0.03, and 1.8% vs. 0.5%; hazard ratio, 3.69; 95% CI, 1.03 to 13.24; P=0.03, respectively), owing mainly to an increase in HIV-associated cancer. CONCLUSIONS In patients with tuberculous pericarditis, neither prednisolone nor M. indicus pranii had a significant effect on the composite of death, cardiac tamponade requiring pericardiocentesis, or constrictive pericarditis. (Funded by the Canadian Institutes of Health Research and others; IMPI ClinicalTrials.gov number, NCT00810849.).
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Mittal SR. Occult constrictive pericarditis. J Assoc Physicians India 2014; 62:279-281. [PMID: 25327079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Four cases of occult pericardial constriction are presented. This condition is not uncommon, but needs high index of suspicion. Integration of detailed echocardiographic evaluation in a given patient with diseases known to cause pericardial involvement can clinch the diagnosis.
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Akpınar I, Tüfekçioğlu O, Yücel E, Okten RS. Pseudocirrhosis; constrictive pericarditis due to huge calcific pericardial cystic mass compressing right cardiac chambers. Anadolu Kardiyol Derg 2012; 12:E24-E25. [PMID: 22626665 DOI: 10.5152/akd.2012.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Ibrahim Akpınar
- Department of Cardiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak-Turkey.
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Ruiz-Cano MJ, Fernández-Ruiz M, Sánchez V, López-Medrano F. Constrictive pericarditis due to Candida albicans: an unexpected cause of pericardial effusion after heart transplantation. Rev Clin Esp 2012; 212:551-2. [PMID: 22795439 DOI: 10.1016/j.rce.2012.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 05/18/2012] [Accepted: 05/26/2012] [Indexed: 11/18/2022]
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Johnen J, Radermecker MA, Defraigne JO. [Constrictive pericarditis: case report and review]. Rev Med Liege 2012; 67:107-112. [PMID: 22611825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Constrictive pericarditis (CP) is a common disease with difficult diagnosis. We report a well-documented case of CP with extended pericardial calcification treated by total pericardiectomy. A brief review of symptoms and signs of CP is presented, as well as additional examination allowing the diagnosis to be confirmed. The differential diagnosis with restictive cardiomyopathy is also discussed.
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Malikova MS, Dombrovskaia AV, Shapieva AN, Fedorov DN, Aksiuk MA. [The constrictive pericarditis of the brucellar etiology]. Khirurgiia (Mosk) 2012:52-53. [PMID: 23235380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Darocha S, Paczek A, Wawrzyńska L, Szturmowicz M, Kober J, Kurzyna M, Oniszh K, Langfort R, Litwiński P, Torbicki A. [Constrictive pericarditis as complication of viral respiratory infection]. Kardiol Pol 2012; 70:392-395. [PMID: 22528716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 24 year-old man with 3-months medical history of recurrent respiratory infections and pericardial effusion, despite treatment with nonsteroid anti-inflammatory drugs, was admitted to the hospital with dyspnea on exertion. On admission he presented the symptoms of right heart insufficiency. Computed tomography of the chest demonstrated a thickened pericardium. Echocardiographic examination and right heart catheterisation established the diagnosis of constrictive pericarditis. Serologic tests suggested viral aetiology. The patient was referred to cardiothoracic surgery, partial pericardiectomy was performed with marked haemodynamic improvement.
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Affiliation(s)
- Szymon Darocha
- Klinika Krążenia Płucnego i Chorób Zakrzepowo-Zatorowych CMKP, ECZ - Otwock.
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Ghavidel AA, Gholampour M, Kyavar M, Mirmesdagh Y, Tabatabaie MB. Constrictive pericarditis treated by surgery. Tex Heart Inst J 2012; 39:199-205. [PMID: 22740731 PMCID: PMC3384050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We reviewed the records of 45 patients (mean age, 46.6 ± 14.9 yr; range, 21-84 yr) with a diagnosis of constrictive pericarditis who had undergone pericardiectomy from 1994 through 2006. Preoperatively, 2 of the patients (4.4%) were in New York Heart Association (NYHA) functional class I, 20 (44.4%) in class II, 22 (48.9%) in class III, and 1 (2.2%) in class IV. Pericardial calcification was detected in 20% of plain chest radiographs. Constrictive pericarditis was caused by tuberculosis in 22.2%, chronic renal failure in 8.9%, a history of sternotomy in 4.4%, and malignancy in 4.4%. The cause was idiopathic in 60% of the patients. Low-output state was the most common postoperative problem (22.2%). The mean follow-up period was 40 ± 18 months (range, 3-144 mo). Three months postoperatively, only 1 of 43 available patients (2.3%) was in NYHA class III, while the rest were in class I (36 patients; 83.7%) or II (6 patients; 14%). The overall mortality rate was 4.4%: 1 patient with tuberculosis died of respiratory insufficiency while hospitalized, and 1 died of metastatic adenocarcinoma during follow-up. Our results show that pericardiectomy remains an effective procedure in the treatment of constrictive pericarditis. Tuberculosis is still an important cause of constrictive pericarditis in Iran, despite intensive vaccination and use of antitubercular drugs.
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Affiliation(s)
- Alireza A Ghavidel
- Department of Cardiovascular Surgery, Rajaee Cardiovascular Medical Research Center, Tehran University of Medical Science, 1996911151 Tehran, Iran.
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Gökçe I, Gökçe S, Kılıç A, Bozlar U, Kocaoğlu M, Ongürü O, Gök F. Familial Mediteranean fever with protein-losing enteropathy due to constrictive pericarditis. World J Pediatr 2011; 7:365-7. [PMID: 21210266 DOI: 10.1007/s12519-011-0255-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 03/21/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Constrictive pericarditis (CP) represents a rare cause of protein-losing enteropathy (PLE) resulting from intestinal lymphangiectasia (IL). In this report, we describe an 8-year-old Turkish boy with IL and PLE secondary to CP. METHODS The boy was introduced to our clinic due to bilateral pretibial edema and swelling of the eyelids caused by hypoproteinemia. Physical examination revealed a distended right jugular vein. Laboratory investigation revealed PLE with fecal concentration of alpha-1 antitripsin of 4.87 mg/g. Histopathologic examination of random biopsies obtained from the duodenum revealed markedly dilated lymphatics compatible with IL. Constrictive pericarditis was diagnosed by tagged cine cardiac magnetic resonance imaging. RESULTS Pericardiectomy was performed for the patient. Genetic analysis was done and heterozygous mutation E148Q was detected as a disease-causing Mediterranean fever (MEFV) mutation. Colchicine was started after the operation. Six months after the initiation of regular colchicine therapy, echocardiography revealed disappearance of CP. CONCLUSION This is the first reported case of PLE with a distended right jugular vein due to CP secondary to familial Mediterranean fever associated with E148Q heterozygosity in the MEFV gene.
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Affiliation(s)
- Ibrahim Gökçe
- Department of Pediatric Nephrology and Rheumatology, Gülhane Military Academy of Medicine, School of Medicine, 06018 Etlik, Ankara, Turkey.
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Raaz U, Buerke M, Stoevesandt D, Thermann P, Friedrich I, Schlitt A, Ebelt H, Müller-Werdan U, Rienmüller R, Silber RE, Werdan K. Massive ascites generation following pacemaker infection: a case report. Clin Res Cardiol 2011; 100:945-9. [PMID: 21701873 DOI: 10.1007/s00392-011-0328-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 05/23/2011] [Indexed: 01/30/2023]
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Banach M, Zapolski T, Drozd J, Wysokiński A. [The concomitance of pericarditis constrictiva in patient with Silver-Russell syndrome, primary hyperparathyroidism and oncologic history: causal coincidence or pathogenetic sequence?]. Kardiol Pol 2011; 69:1174-1176. [PMID: 22090232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The most common cause of calcific pericarditis is idiopathic. We report a case of a 24 year-old woman with Silver-Russell syndrome, history of Wilms' tumour in childhood, constrictive pericarditis and primary hyperparathyroidism. We analyse pathologic mechanisms of disseminated calcification and possible genetic factors that may contribute to aetiology and clinical presentation of calcific pericarditis.
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Affiliation(s)
- Monika Banach
- Katedra i Klinika Kardiologii, Uniwersytet Medyczny w Lublinie, Lublin
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Gogin EE, Sidorenko BA, Erokhina MG, Belous MA, Nunuparova MM, Vasechkin SS, Kambarov SI, Morozov SP, Alekhin MN. [Diagnosis and effective surgical treatment of constrictive pericarditis]. Kardiologiia 2011; 51:91-96. [PMID: 21942966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Constrictive pericarditis is a rare and severe disease. Timely and correct differential diagnosis of this pathology facilitates choice of necessary tactics of treatment and thus improve prognosis and quality of life. In this paper we present clinical case report of a patient with constrictive pericarditis. The disease was diagnosed on the basis of clinical picture, data of X-ray and echocardiographic investigation, and confirmed by multispiral computed tomography (MSCT). The patient was subjected to pericardioectomy with positive clinical effect and results of repeated echocardiography and MSCT.
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MESH Headings
- Adult
- Antitubercular Agents/administration & dosage
- Combined Modality Therapy
- Diagnosis, Differential
- Echocardiography, Doppler
- Humans
- Isoniazid/administration & dosage
- Male
- Monitoring, Physiologic
- Pericardial Effusion/etiology
- Pericardial Effusion/physiopathology
- Pericardial Effusion/therapy
- Pericardiectomy/methods
- Pericardiectomy/rehabilitation
- Pericarditis, Constrictive/diagnosis
- Pericarditis, Constrictive/etiology
- Pericarditis, Constrictive/physiopathology
- Pericarditis, Constrictive/therapy
- Pericarditis, Tuberculous/complications
- Pericarditis, Tuberculous/pathology
- Pericarditis, Tuberculous/physiopathology
- Pericarditis, Tuberculous/therapy
- Pericardium/pathology
- Pericardium/surgery
- Perioperative Care
- Rare Diseases
- Severity of Illness Index
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
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Affiliation(s)
- Shernan G Holtan
- Transplatation Medicine Program, Mayo Clinic, Rochester, MN 55905, USA
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Imazio M, Brucato A, Mayosi BM, Derosa FG, Lestuzzi C, Macor A, Trinchero R, Spodick DH, Adler Y. Medical therapy of pericardial diseases: part II: Noninfectious pericarditis, pericardial effusion and constrictive pericarditis. J Cardiovasc Med (Hagerstown) 2010; 11:785-794. [PMID: 20925146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The treatment of pericardial diseases is largely empirical because of the relative lack of randomized trials compared with other cardiovascular diseases. The main forms of pericardial diseases that can be encountered in the clinical setting include acute and recurrent pericarditis, pericardial effusion with or without cardiac tamponade, and constrictive pericarditis. Medical treatment should be targeted at the cause as much as possible. In this article, the therapy of more common forms of noninfectious pericarditis (pericarditis in systemic autoimmune diseases and neoplastic pericardial disease), pericardial effusion, and constrictive pericarditis is reviewed.
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Affiliation(s)
- Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy.
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47
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Mathew B, Francis G. Suppurative odontogenic infection causing pyopericardium. Natl Med J India 2010; 23:374-375. [PMID: 21561056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Hadjimiltiades S, Efthimiades G, Spanos P. Segmental diastolic compression of venous and arterial conduits post coronary artery bypass surgery. J Invasive Cardiol 2010; 22:E150-E152. [PMID: 20679681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In a case of constrictive pericarditis post coronary artery bypass surgery we describe the diastolic compression of venous and arterial conduits and the timing of compression, as demonstrated during angiography, before and after pericardiectomy. In conclusion, angiographic demonstration of conduit compression is only suggestive of constriction, and consideration of the timing of compression during diastole should be a more specific sign.
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Affiliation(s)
- Stavros Hadjimiltiades
- Cardiology Clinic, AHEPA University Hospital, Stilponos Kyriakide 1, Thessaloniki, Greece.
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Abstract
We present a case of a 69-year-old woman with constrictive pericarditis preceded by effusive-constrictive pericarditis. Echocardiography on admission revealed a mild pericardial effusion, pericardial thickening and a constrictive physiology in the absence of RV pressure/volume overload suggesting effusive-constrictive pericarditis. Echocardiographic follow-up showed gradual disappearance of the effusion within one month and an important thickening of the visceral and parietal pericardium up to 9 mm. Respiratory variation of the mitral and tricuspid inflow, prominent diastolic septum shift and high mitral annular TDI-velocities were indicative of constrictive pericarditis. Subsequent left/right heart catheterisation 3 months after the initial diagnosis confirmed constrictive pericarditis with elevated diastolic pressures equalized in the four heart chambers, square root sign, respiratory discordant change of the left and right systolic pressures and an inspiratory increase of the right atrial pressure. The patient remained symptomatic under treatment with aspirin and diuretics. A parietal and visceral pericardectomy was successfully performed with a favourable clinical evolution.
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Affiliation(s)
- Alex Heyse
- Dept. of Cardiology, AZ ZVB Ronse, Belgium.
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Cuevas Valenzuela P, Rufino Ruiz J, Palacios Blanco E. [Mulibrey syndrome: anesthetic management]. Rev Esp Anestesiol Reanim 2010; 57:186-188. [PMID: 20422854 DOI: 10.1016/s0034-9356(10)70196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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